Cybele Fishman, MD, Martin C Mihm, MD, Arthur J Sober, MD

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Presentation transcript:

Diagnosis and management of nevi and cutaneous melanoma in infants and children Cybele Fishman, MD, Martin C Mihm, MD, Arthur J Sober, MD Clinics in Dermatology Volume 20, Issue 1, Pages 44-50 (January 2002) DOI: 10.1016/S0738-081X(01)00227-9

Figure 1 A giant congenital nevus. This large congenital nevus covers practically the entire trunk of this child, extending from the neck to the buttocks. Note the raised areas that represent compound nevi. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 2 A giant congenital nevus. These lesions often show strikingly pigmented zones that are usually histologically benign nodules. Areas such as the dark oval, however, must be biopsied. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 3 A giant congenital nevus. Morphologically, the giant congenital nevus characteristically is associated with a proliferation of cells that extend from the dermis into the subcutaneous fat in a very diffuse manner. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 4 A giant congenital nevus. Subendothial proliferation of nevus cells is common in congenital nevi. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 5 A giant congenital nevus. This lesion shows a proliferation of nevus cells from the epidermis into the subcutaneous fat, a common finding in congenital nevi. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 6 Small congenital nevus. These lesions can vary in size from a few millimeters to several centimeters. This lesion, on the scalp, was present at birth. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 7 Small congenital nevus. This lesion shows clinical features of a small congenital nevus. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 8 Cutaneous melanoma arising in a small congenital nevus. The area of darkening represented a superficial spreading melanoma, superficially invasive, arising in a small congenital nevus. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 9 Congenital combined nevus. This lesion, was clinically suspicious for malignant melanoma. Biopsy showed a combined blue/congenital nevus. From Clemente C, et al. Melanoma E nevi, Effetti Milano, 1997, with the permission of Effetti and Professor N. Cascinelli, Scientific Director of the Istituto Nazionale dei Tumori. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 10 De novo melanoma. This irregularly colored lesion arose rapidly on the shoulder of a 9-year-old girl. Note the irregularities in color similar to adult melanoma. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)

Figure 11A, B De novo melanoma. Biopsy of the lesion on the shoulder showed (on low power) (Fig 11A) a nodule of proliferative melanocytes, which on high power (Fig 11B) showed pleomorphic cells with numerous mitoses with a count of approximately 20 per millimeter squared. This patient succumbed to her melanoma. Clinics in Dermatology 2002 20, 44-50DOI: (10.1016/S0738-081X(01)00227-9)